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able to swallow any of it. He would throw himself about as though struggling for air, and was inclined to roll over toward the left side. He did not seem to the attendants like a man fatally hurt, but rather like one who had been badly shaken up by a severe fall and who had severe colicky pains. The surgeon on duty, who happened to be Dr. Newton, was summoned, but before his arrival the man quietly died. There had been no vomiting, and the bladder had not been emp- tied. There had been no convulsions or spitting of blood. Dr. Washington, the county physician, was notified, and on the following day permitted a par- tial autopsy. Differin Gel Buy The body was that of a well-nourished, muscular young man. Except two or three unimpor- tant abrasions on the legs and a small punched-out semicircular mark on the skin over the sixth rib on the left side, no external injuries were noted. An inch or two Coupon For Differin Gel inside of the semicircular mark just referred to was a slight depression of the surface, and pressure over this elicited the fact that the sixth costal cartilage had Generic Differin Gel been fractured. On opening the chest nothing abnor- mal was observed, except the fracture, as noted above, and some laceration of the neighboring intercostal mus- cles. The pleura and pericardium were intact. The lat- ter, however, appeared somewhat distended, and on opening it from eight to ten ounces of dark clotted blood were observed between its pericardial and epicardial lay- ers. When the heart was lifted it was observed to be about normal in size, perhaps a little hypertrophied ; the walls were relaxed and the cavities contained a few post-mortem clots. A rather large transverse rent, with everted edges, was noted at the apex of the right ven- tricle. The measurements of the rent were an inch and a half externally and three eighths of an inch internally. The internal opening was immediately contiguous to the interventricular sa>ptum. Dr. Newton said that he thought there was no doubt that the tear Differin Xp Gel had been made from without inward ; that Differin Canada the heart had been struck in systole by Differin Adapalene Cream 0.1 the Order Differin Online broken end of the sixth costal cartilage, which had pushed the pericardium before it and ruptured the ventricular wall at its thinnest portion without tearing the pei-icardium. Dr. Manoes opposed this view of the receipt Buy Differin Gel 0.3 of the Buy Differin Gel Online injury, maintaining that the probabilities were strongly in favor of a rupture from Differin Vs Epiduo within outward. Dr. Rupp agreed with the first speaker, and thought that as the external wound was so much larger than the internal, and the history pointed so strongly toward direct injury, there was little doubt that the rent had occurred as Dr. Newton suggested. Dr. Newton called attention to the fact that the heart was of about normal size, and possibly a little hy|)(!rfrophied ; that the muscle fibres were apparently quite healthy; that the suliject was an athU'tic young man in excellent physical condition, and an experiencHHl bicycle rider. There was no likelihood, therefore, of a spontaneous rujiture, Differin For Acne Scars as the cardiac structures wore in an excellent condition, and, as to a rn])ture from strain, ho doubted if Differin Lotion Coupon it ever occurnvl through healthy ven- trifiilnr walls. June 3, 1899.] BOOK yOTICES. r97 He regretted that he had not had time to investigate this ease thoroughly or to look up Where To Buy Differin Gel the literature of the subject, but he intended to do so, and would report later to this society or some other in reference to the matter. ^ook Hotifcs. The Pathology and Treatment of Sexual Impotence. By Victor G. Vkcki, M. D. From the Author's Sec- ond German Edition, revised and rewritten. Phila- delphia : W. B. Saunders, 1899. Pp. 11 to 291. [Price, $2.] This work should prove of great interest and value to the practitioner, for, as the author says in his intro- duction, " it must be admitted that the subject has never received the attention its preeminent importance de- serves. The world over, it seems to be considered the proper thing to treat the affair with supercilious non- chalance." Yet reflection will surely make it clear that a subject which is the natural basis of love, the founda- tion of the home and the famih", Differin Gel Online which is intimately as- sociated with the character and general appreciation Differin And Acne Scars of life, and with the mental, moral, and physical well-being of the entire organism, can not be so universally neg- lected without evil consequences as far reaching as the sexual functions themselves. How often is not suicide the result, direct or indi- rect, of impotence? Strong as the statement is, we feel that it is not altogether wide Epiduo Vs Differin of the mark when the au- thor says : " I venture to assert that in many cases it is a better deed to restore to an impotent man the powers, so precious to every individual, than to preserve a dan- gerously sick person Buy Differin Cream from death, for in many cases death is proferaiile to impotence." The work deals systematically and in detail with the anatomy of the male genital organs and the physiology of the sexual act. The author then discusses the .Ttiol- ogy of impotence, and its forms, which he subdivides into five ciassci* — viz.: 1. Tiiat due to congenital mal- fornintions and defects of the sexual organs. 2. That due to Differin Oily Skin acquired defects. 3. Consecutive impotence. 4. That due to inherited i)redisposition. 5. Neurasthenic ini[)<)tfnce. Tlie Differin Gel Generic diagnosis, prognosis, and prophylaxis are next treated of in separate cliapters, and finaliy the subject of trentment is dealt with in a most exhaustive manniT in all its phases. This section is especially " up to dnfe."

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